title: Use of the exercise treadmill to measure baseline functional status and surgical outcome in patients with severe lumbar spinal stenosis.
abstract: METHODS
  A prospective study of exercise tolerance on the treadmill before and after decompressive laminectomy in patients with severe lumbar spinal stenosis.
  
  
  OBJECTIVE
  To determine whether treadmill testing provides useful information about baseline functional status and surgical outcome.
  
  
  BACKGROUND
  Historically, criteria for selecting patients for surgery and assessing postoperative outcome have been variable. Functional testing has not been used in a systematic fashion.
  
  
  METHODS
  Fifty patients with severe lumbar spinal stenosis underwent decompressive laminectomy. Preoperatively and 3 months postoperatively, functional capacity was assessed on an exercise treadmill. Time to first symptoms and total ambulation time were recorded. The examination was stopped at the onset of severe symptoms or after 15 minutes.
  
  
  RESULTS
  In the preoperative trial, mean time to first symptoms (+/- standard deviation) was 1.82 minutes (median, 0.58), and mean total ambulation time was 6.91 minutes (median, 5.22). In the postoperative trial, mean time to first symptoms increased to 11.93 minutes (median, 15) and mean total ambulation time increased to 13.26 minutes (median, 15). There was significant improvement after surgery in both time to first symptoms (P < 0.001) and total ambulation time (P < 0.001).
  
  
  CONCLUSIONS
  Exercise stress testing on a treadmill is a safe, easily administered, and quantifiable means of assessing baseline functional status and surgical outcome in patients with neurogenic claudication due to lumbar spinal stenosis. Treadmill testing provides objective evidence that surgery is beneficial in most cases and is helpful in guiding subsequent management of patients with residual symptoms.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Scottsdale, Arizona, USA.
authors.forename: H G
authors.initials: HG
authors.lastname: Deen
authors.forename: R S
authors.initials: RS
authors.lastname: Zimmerman
authors.forename: M K
authors.initials: MK
authors.lastname: Lyons
authors.forename: M C
authors.initials: MC
authors.lastname: McPhee
authors.forename: J L
authors.initials: JL
authors.lastname: Verheijde
authors.forename: S M
authors.initials: SM
authors.lastname: Lemens
mesh_terms: D000368:Aged; D005080:Exercise Test / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D011184:Postoperative Period; D013130:Spinal Stenosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking